Stapled vs sutured colorectal anastomosis.

Performance of low, anterior colorectal anastomosis by means of stapled end-to-end anastomoses and hand sutures was achieved in 51 patients. Among the 26 stapled anastomoses, leakage and external fistula were observed in two cases, but subsequent surgery has never been necessary. Conversely, hand sutures were associated with external fistula again in two cases, but leakage and peritonitis were observed in two other cases. It is suggested that stapled anastomoses are at least as reliable as sutured, colorectal anastomoses. Moreover, the stapling device enables the surgeon not only to extend the range of anterior resection to lower tumors but also to extend the level of resection below the tumor.